What's Changing

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Highlights for the 2020 Benefits Plan Year

Medical

Aetna

  • Aetna is adding a new POS 30 MDCR plan to the New York Tri-state region. This plan has a $0 deductible.
  • Aetna is replacing the HDHP 2700 plans with HDHP 3000 plans. If worksite employees are currently enrolled in one of these plans, they must actively make an election during Open Enrollment or they will be automatically enrolled in the most comparable HDHP 3000 plan.*

    *Worksite employees that reside in Massachusetts will be automatically enrolled in the PPO 2000 plan to remain compliant with Massachusetts Minimum Creditable Coverage requirements.

  • Aetna is adding two PPO 7150 plans as follows:

Plan Name

Network

States Available

Aetna PPO 7150

Open Access Managed Choice POS

Nationwide except for Massachusetts, Missouri and the New York Tri-state region.

Aetna Choice PPO 7150

Open Choice

Missouri and regionally.

  • Prescription drug copays for Tier 3 medications on the Aetna ACO plans in Texas, Arizona and Colorado will change from 50% coinsurance to a $75 copay.
  • The in-network family deductible and maximum out-of-pocket expenses for some Aetna medical plans will be changing. Please see the table below.

Plan Name

Family In-Network Deductible

Family In-Network
Out-of-Pocket Maximum

Current

New

Current

New

Aetna PPO 750*

$2,250

$1,500

$7,500

$5,000

Aetna PPO 1000*

$3,000

$2,000

$12,000

$8,000

Aetna PPO 3000

$9,000

$6,000

$12,000

$8,000

Aetna Indemnity 1000

$3,000

$2,000

$12,000

$8,000

Aetna PPO Choice 500

$1,500

$1,000

$9,000

$6,000

Aetna EPO 1000

$3,000

$2,000

$12,000

$8,000

*Does not apply in the Tri-state region. 


Blue Cross and Blue Shield of North Carolina (BCBSNC)

  • The PPO 3500 Copay plan will have significant plan design changes. Click here to see a comparison of the current plan design and the new plan design.
  • Emergency room copays are changing for the PPO 500 and PPO 1000 plans from $150 to $250.
  • The Blue Premier service model is being added. There are five healthcare systems that are part of this accountable care organization: Cone Health, Duke Health, UNC Healthcare, Wake Forest Baptist Health and WakeMed.
  • Office visit copays for primary care physicians (PCPs) are changing on the PPO 500 and PPO 3500 plans as shown below.

Plan Name

Current PCP/Specialist Copay

New PCP/Specialist Copay

BCBSNC PPO 500

$20 visit/$30 visit

$25 visit/$35 visit*

BCBSNC PPO 3500

Tier 1: $25 visit/$50 visit

Tier 2: $75 visit

$35 visit/$70 visit

*Change not applicable in Massachusetts.

  • BCBSNC is replacing the HDHP 2700 plan with an HDHP 3000 plan. If worksite employees are currently enrolled in this plan, they must actively make an election during Open Enrollment or they will be automatically enrolled in the HDHP 3000 plan.*

    *Worksite employees that reside in Massachusetts will be automatically enrolled in the PPO 500 MA plan to remain compliant with Massachusetts Minimum Creditable Coverage requirements.

    Blue Shield of California (BSCA)

    • BSCA is adding an ACO/PPO 1700 plan in the Tandem network.
    • BSCA is replacing the HDHP 2700 plan with an HDHP 3000 plan. If worksite employees are currently enrolled in this plan, they must actively make an election during Open Enrollment or they will be automatically enrolled in the HDHP 3000 plan.*

      *Worksite employees that reside in Massachusetts will be automatically enrolled in the PPO 1500 plan to remain compliant with Massachusetts Minimum Creditable Coverage requirements.

    • Emergency room (ER) copays are changing for all BSCA HMO and ACO plans. See chart below.

    Plan Name

    Current ER Copay

    New ER Copay

    BSCA HMO 20

    $100

    $250

    BSCA HMO 30

    $150

    $250

    BSCA ACO 25

    $100

    $250

    BSCA ACO 40

    $100

    $250

    Empire

    • Empire is being added as a carrier choice for clients headquartered in New York in the Empire service areas (based on ZIP code). Check with your Customer Experience contact to see if this carrier is available in your county. The Blue Card option will be available for worksite employees outside of New York. To see a list of the plans that are being offered, click here, or to view a brochure that describes Empire‚Äôs value-added services, click here.

    Florida Blue

    • Florida Blue is adding a PPO 500/80 plan.
    • Florida Blue is replacing the HDHP 2700 plan with an HDHP 3000 plan. If worksite employees are currently enrolled in this plan, they must actively make an election during Open Enrollment or they will be automatically enrolled in the HDHP 3000 plan.*

    • *Worksite employees that reside in Massachusetts will be automatically enrolled in the PPO 2000 plan to remain compliant with Massachusetts Minimum Creditable Coverage requirements.

    Kaiser

    • Kaiser is replacing the HMO/HDHP 2700 plan with an HMO/HDHP 3000 plan. If worksite employees are currently enrolled in this plan, they must actively make an election during Open Enrollment or they will be automatically enrolled in the HMO/HDHP 3000 plan.
    • Kaiser is adding the following medical plans:

    Plan Name

    States Available

    Kaiser HDHP 6650

    Colorado and Georgia

    Kaiser HMO 3000

    Colorado and Georgia

    Kaiser POS HI

    Hawaii

    Tufts

    • Tufts Teladoc telehealth services are being reduced to $5 per visit for all members enrolled in a non-HDHP, and $45 for those who are enrolled in an HDHP. Teladoc is a telehealth service that offers quality healthcare whenever you need it. Connect with licensed doctors 24/7 online via computers, tablets and mobile devices.
    • Tufts is adding a PPO 2000 plan in Massachusetts.

    UnitedHealthcare (UHC)

    • UHC is adding two new plans: an HDHP 1500 and a PPO 7150.

    Plan Name

    Network

    States Available

    UHC HDHP 1500

    Choice Plus

    Nationwide except Hawaii, Nevada and Puerto Rico

    UHC PPO 7150

    Choice Plus

    Nationwide except Massachusetts, Hawaii, Nevada and Puerto Rico

    • UHC is eliminating the POS 1500 and POS 2500 plans. Worksite employees who do not actively make an election during Open Enrollment will be automatically enrolled in the most comparable UHC plan as shown below:

    Current Plan

    New Plan

    UHC POS 1500

    UHC Primary 1500

    UHC POS 2500

    UHC Primary 2500

    • Emergency room copays are changing for the UHC PPO 2500 plan from $200 to $350.
    • UHC is replacing the HDHP 2700 plan with an HDHP 3000 plan. If worksite employees are currently enrolled in this plan, they must actively make an election during Open Enrollment or they will be automatically enrolled in the HDHP 3000 plan.*

    • *Worksite employees that reside in Massachusetts will be automatically enrolled in the PPO 1500 plan to remain compliant with Massachusetts Minimum Creditable Coverage requirements.

    Dental

    • The national dental plans offered by MetLife are replacing the state-specific dental plans in Louisiana, Mississippi, Montana and Texas. This change will impact out-of-network coinsurance and copays. Worksite employees who do not actively make an election during Open Enrollment will be automatically enrolled in the most comparable MetLife dental plan.

    Vision

    • No plan design changes.

    Flexible Spending Accounts (FSAs) and Health Savings Account (HSA)

    • The maximum health care FSA annual contribution limit for the 2020 benefits plan year will increase by $50 to $2,750. The maximum dependent day care FSA annual contribution limit for the 2020 benefits plan year remains unchanged at $5,000.
    • The maximum HSA single contribution limit for the 2020 calendar year is $3,550. The maximum HSA family contribution limit for the 2020 calendar year is $7,100.

    Disability

    • Disability coverage will be administered through The Hartford as a result of their acquisition of the Aetna group disability business. There will be no plan changes or disruption in coverage.
    • Effective April 1, 2020, worksite employees who work in Washington State, as well as clients with worksite employees working in Washington State, who elect short-term disability, will have reduced rates due to Washington State Paid Family Leave.
      • Should a worksite employee become disabled, they will need to file for short-term disability benefits with both the state of Washington and The Hartford.
      • The benefit that worksite employees are eligible to receive from The Hartford will be offset with any state-paid family leave benefits that they receive.

    Life and AD&D Insurance

    • No plan design changes.

    Voluntary Benefits

    • No changes to the existing voluntary benefit plans.

    Voluntary Benefit Plans

    Aflac

    MetLife

    Aflac Group Critical Illness Insurance

    MetLife/Hyatt Legal Plan

    Aflac Group Hospital Indemnity Insurance

    MetLife Pet Insurance

    Aflac Group Accident Insurance

    MetLife Auto and Home Insurance

    Other Benefits

    • The maximum commuter benefits monthly contribution limit for the 2020 calendar year will increase by $5 to $270 for both qualified parking and public transit expenses.
    • No plan design changes to the Employee Assistance Program.